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Objective: To explore the effect and mechanism of hirudin on atherosclerotic plaques in apolipoprotein E knockout (ApoE(-/-)) mice., Methods: Totally 24 ApoE(-/-) mice, 7-8 weeks old were fed with high fat diets. They were randomly divided into the recombinant hirudin treatment group (drug group) and the model group according to body weight and different dens, 12 in each group. Twelve C57BL/6J mice, 7-8 weeks old fed with high fat diet were recruited as the normal control group. Recombinant hirudin (0.25 mg/kg) was intraperitoneally injected to mice in the drug group from the 10th week old once every other day for five successive weeks. Equal volume of normal saline was injected to mice in the model group. Mice in the normal control group received no treatment. All mice were sacrificed after fed with high fat diet until they were 20 weeks old. Serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), high-sensitive C-reactive protein (hs-CRP), E-selectin, interleukin-6 (IL-6), and stromal metalloproteinase-2 (MMP-2) were detected. The plaque/lumen area and extracellular lipid composition/ plaque area were analyzed by HE staining and morphometry. Changes of signaling molecules in store-operated calcium channels, including stromal interacting molecule 1 (STIM1), Orail protein, and transient receptor potential channel 1 (TRPC1) were determined by Western blot. Results Lipid plaque formed in the aorta vessel wall of 20-week old mice in the model group. Compared with the normal control group, serum levels of TC, TG and LDL increased (P<0.01), hs-CRP, E-selction, IL-6, and MMP-2 obviously increased (P<0.01, P<0.05) in the model group; expression levels of STIM1, TRPC1, and Orail significantly increased (P<0.01). Compared with the model group, the plaque/lumen area and the extracellular lipid composition/plaque area significantly decreased in the drug group (P<0.05, P<0.01); serum levels of TC and LDL, hs-CRP, E-selction, IL-6, and MMP-2 obviously decreased (P<0.05, P<0.01); expression levels of STIM1, TRPC1, and Orail were significantly down-regulated (P<0.05, P<0.01)., Conclusion: Hirudin could significantly improve lipids and endothelial functions of ApoE(-/-) mice, down-regulate expression levels of STIM1, Orai1, and TRPC1, and thus delaying the occurrence and development of atherosclerosis.

Objective: To study the changes of adenosine diphosphate (ADP)-induced platelet aggregation rate, and evaluate the effects of Maixuekang Capsule (MC) on the platelet aggregation rate, high-sensitive C-reactive protein (hs-CRP) and the long-term prognosis in patients with acute coronary syndrome under percutaneous coronary intervention (PCI)., Methods: Totally 236 inpatients with acute coronary syndrome under PCI, who successively received PCI from July 2008 to June 2010, were randomly assigned to the routine treatment group (RTT, 120 cases) and the MC treatment group (MKT, 116 cases). Besides routine medication, patients in the MKT group additionally took MC, 12 capsules daily for 12 successive months. The ADP-induced platelet aggregation rate and hs-CRP concentration were determined before PCI, 12 h and 30 days after PCI. In the meantime, the incidence of adverse cardio-/cerebrovascular events was recorded during the twelve-month clinical follow-up. Results Compared with before PCI, ADP-induced platelet aggregation rate and the serum hs-CRP concentration were significantly higher 12 h after PCI (P < 0.05). They were significantly reduced after 30-day treatment of MC, showing statistical difference when compared with those in the RTT group (P < 0.05). In the 12-month follow-up, the incidence of adverse cardio-/cerebrovascular events was significantly lower in the MKT group than in the RTT group (6.9% vs 12.5%, P < 0.01)., Conclusions: ADP-induced platelet aggregation function was significantly elevated after PCI, which was a predictive factor of poor coronary events. MC improved the long-term prognosis of patients with acute coronary syndrome possibly through inhibiting the platelet aggregation rate and the hs-CRP concentration.

Objective: To investigate the relationship between the guidelines issued by the American College of Cardiology/American Heart Association (ACC/AHA) in 2004 and the changes in early reperfusion, drug treatment and outcome of inpatients with acute myocardial infarction (AMI) in China, and to explore what extent the guidelines are followed in the management of AMI in China, and the differences in managements and patients' outcome after its issue., Methods: A retrospective study of clinical data of 1 278 patients with AMI admitted to 12 Chinese Hospitals from January 2002 to December 2006 was carried out. They were divided into two groups: group A included 734 patients admitted from January 2002 to August 2004, and group B comprised 544 patients admitted from August 2004 to December 2006. The baseline characteristics, early reperfusion, drug treatment, reinfarction, angina pectoris, heart failure, cardiogenic shock, bleeding and death were compared between two groups. The correlation between therapeutic measure and mortality was analyzed to estimate the difference between two groups, and relationship between the differences and the guidelines issued in 2004 was also analyzed., Results: The age, sex, systolic blood pressure, history of past illness excepting old myocardial infarction of patients with AMI bore no significant difference between two groups. The incidence of Killip≥III in group B was lower significantly than that in group A (7.5% vs. 14.7%, P<0.01). Reperfusion therapy was used more often in group B than in group A (78.5% vs. 71.2%, P<0.05). And percutaneous coronary intervention (PCI) therapy was used more often in group B than in group A (71.5% vs. 61.0%, P<0.01). However, the rate of lytic treatment was lower in group B than that in group A (8.6% vs. 16.3%, P<0.01). ³ The percentage of use of antiplatelet drug and aspirin was both over 97.0%. The tidopidine was used more frequently in group A than in group B (54.9% vs. 8.3%), and the clopidogrel and glycoprotein IIIa/IIb antagonists was used more frequently in group B than in group A (83.8% vs. 27.4%, 4.8% vs. 0.7%, both P<0.01). The angiotensin-converting enzyme inhibitor/angiotensin II receptor antagonist (ACEI/ARB) were administered more frequently in group B than in group A (98.2% vs. 93.5%, P<0.01), and the increasing trend of ARB was obvious (13.6% vs. 4.4%, P<0.05), but the decreasing trend of ACEI was obvious also (84.6% vs. 89.1%, P<0.01). Heparin/low molecular heparin, β-blocker and statin were used more often in group B than in group A (97.4% vs. 94.8%, 80.1% vs. 74.8%, 87.7% vs. 82.4%, P<0.05 or P<0.01). (4) In-hospital mortality, reinfarction, angina pectoris were lower in group B than in group A (4.6% vs. 7.6%, 2.8% vs. 4.8%, 8.4% vs. 12.4%, all P<0.05). (5) Multivariate Logistic regression analysis showed that reperfusion, antiplatelet drug, statin and heparin/low molecular heparin were associated significantly with in-hospital mortality (all P<0.05)., Conclusion: After guideline was issued by ACC/AHA in 2004, the regime of early reperfusion and drug treatment in China had followed more closely the recommendations of the guidelines. At the same time, in-hospital mortality, reinfarctions, angina pectoris were decreased. And the changes in strategy of early reperfusion, antiplatelet drug, statin and heparin/low molecular heparin are closely related with in-hospital mortality. However, current management of AMI in China has not followed the recommendations of guidelines closely. It is essential to promote the use of β-blocker and ACEI/ARB drug treatment in China in accordance with the guidelines.

Objective: To compare the lipid lowering effects of Zhikang Granule (ZKG) and simvastatin., Methods: Forty-five out-patients with hyperlipemia who met the entry criteria were enrolled and randomized into two groups in the ratio of 2: 1, 30 patients in the ZKG group and 15 patients in the simvastatin group. The lipid lowering effects and safety of treatment during the 24-week therapeutic period, as well as the influence of treatment on plasma high sensitivity C reactive protein (hs-CRP) level in patients were observed., Results: No significant difference between the two groups was observed in serum levels of total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C) and triglyceride (TG) at the 4th, 8th, 12th and 24th week (P > 0.05). However, as compared with baseline, significant reduction of TC and LDL-C in both groups was shown at all the observing time points (P < 0.01), while the changes in TG and HDL-C were insignificant (P > 0.05). The control rates of LDL-C and TC in the ZKG group and the simvastatin group were 86.7% (26/30) versus 100% (15/15) at the 4th week, 80.0% (24/30) versus 100% (15/15) at the 8th week, 53.3% (16/30) versus 60.0% (9/15) at the 12th week, and 90.0% (27/30) versus 93.3% (14/15) at the 24th week, respectively, all showed insignificant difference between groups. No statistical differences were found between groups in levels of plasma transaminase, creatinine, uric acid and hs-CRP (P > 0.05)., Conclusion: ZKG has a definite effect in lowering LDL-C and TC, and it is safe in long-term administration.

Objective: To study hypertension control, follow up and the factors associated with the rate of hypertension control., Methods: Through a community-based study, the routine data were collected through a community hypertension managing software for one year., Results: There were 3375 hypertension patients above 60 years old recruited in the information system. In the baseline, the rate of blood pressure control was 63.5%, and arranging intervals up to 6 months was 66.9%. Hypertension control rate for the baseline, the third month and the sixth month was 61.8%, 62.4% and 61.6%, respectively (chi2 = 0.16, P = 0.69). Among hypertensives whose blood pressure was stabilized in baseline, hypertension control rates for the third month and the sixth month was 72.9.8% and 72.1%, respectively (chi2 = 0.26, P = 0.61). Blood pressure stabilized over 6 months in comparing with others, and the proportion for regular taking medication was 96.2% and 97.7% (chi2 = 3.58, P = 0.06). The proportion for physical activity, less salt intake, weight control was significantly higher in the patients whose blood pressure control well over 6 month., Conclusion: Rate of blood pressure control among elderly patient with hypertension who frequently consults the doctor in the community is high. Ineffectiveness in systolic and diabetes control is the important factor, which decreases the rate of blood pressure. Physical activity, less salt intake, and weight control are of help to hypertension control. For those, the blood pressure are stabilized, a follow up with 3 to 6 months interval is appropriate.